Primary Biliary Cholangitis (PBC) is a chronic autoimmune disease that damages the bile ducts in the liver. It causes bile to build up in your liver, resulting in liver inflammation and permanent scarring. Over time, the scarred tissues completely replace healthy liver tissues, preventing them from functioning well.
Bile is a fluid produced by the liver that aids in the digestion of fats, absorption of fat-soluble vitamins, and elimination of toxins from the liver. A bile duct carries this bile from the liver and gall bladder into the small intestine. When bile ducts get damaged, bile builds up, causing liver failure and even death in some cases. Currently, there is no cure for Primary Biliary Cholangitis, but early detection and treatment can slow liver damage.
What causes Primary Biliary Cholangitis?
Well, doctors are not sure. PBC is an autoimmune disease that causes our body’s natural defence system to mistake healthy liver tissues for foreign invaders and attack them. It causes cirrhosis. PBC is progressive and may be triggered by genetic or environmental factors. It is common in families where at least one member is affected. Occasionally, genetic factors combine with environmental conditions like infections, smoking, and toxic chemicals, triggering the disease.
Who is affected by the disease?
Previously called Primary Biliary Cirrhosis, PBC occurs predominantly in middle-aged people 30 to 60 years old. However, according to the NCBI, the disease ratio among men and women is 1:9. An estimated 65 women in every 100,000 in the United States are affected every year.
What are the symptoms?
Patients with Primary Biliary Cholangitis are asymptomatic during the early stages and are incidentally diagnosed when blood tests are done for other reasons. The early symptoms include fatigue, dry eyes and mouth, joint pain, and super itchy skin.
Later symptoms include
- Edema (swollen arms, hands, legs, and feet due to excess fluid trapped in body tissues)
- Osteoporosis causes the bone to become brittle and snap on the mildest of fall
- Enlarged veins in the lining of the oesophagus cause oesophageal varices
- Small skin bumps are caused by the accumulation of fat under the skin
- Pain in the abdomen due to swelling
- Jaundice (yellowing of skin and eyes)
- Spleen enlargement
- High cholesterol
- Weight loss and more.
Diagnosis
Your healthcare provider or the best liver hospital in Chennai will question you about your current symptoms & family medical history and suggest a blood test. The result will indicate liver abnormalities and immune system issues if any. Alternatively, the presence of AMA (Anti-Mitochondrial Antibody) and abnormal levels of cholesterol and triglycerides in blood confirms PBC. Also, a damaged liver releases certain enzymes into the bloodstream that can be assessed by specific liver tests.
If your blood test confirms PBC, your doctor may order imaging tests like MRI, CT Scan, or ultrasound for a detailed look at your liver and surrounding tissues. Sometimes, a liver biopsy is also suggested.
What are the treatment methods?
There is no cure for PBC. But early diagnosis can slow the course of the disease and protect your liver from further damage. Your doctor might prescribe medications that might reduce bile production or remove excess bile secreted in the liver to the small intestine. Immune-suppressing drugs keep your immune system in check. A liver transplant surgery may be the ideal solution when medications don’t help.
Making tweaks to your daily life can go a long way. For the best outcome, stay away from alcohol, smoking, and drugs, follow medications as prescribed by your healthcare provider, exercise, and stay healthy.